In a recent NPR interview about mental illness the following was revealed:
“Psychiatrist [Harold] Schwartz has been a part of the conversation about Connecticut's mental health system that has gained new urgency since the school shootings in Newtown. He says a lot of attention is now being paid to identifying young people with emotional struggles who need help, but when it comes to helping people like Bell [a 54-year old man who eventually committed suicide] homeless, chronically mentally ill adult living in the community — he sees less movement….”
Last December, David Dobbs wrote in the New York Times about “A New Focus on the ‘Post’ in Post-Traumatic Stress.” He stated,
“But it turns out that most trauma victims — even survivors of combat, torture or concentration camps — rebound to live full, normal lives. That has given rise to a more nuanced view of trauma — less a poison than an infectious agent, a challenge that most people overcome but that may defeat those weakened by past traumas, genetics or other factors….”
“In villages where the [child-soldiers] were stigmatized or ostracized, they suffered high, persistent levels of post-traumatic stress disorder. But in villages that readily and happily reintegrated them (usually via rituals or conventions specifically designed to do so), they experienced no more mental distress than did peers who had never gone to war. The lasting harm of being a child soldier, it seemed, arose not from the war but from social isolation and conflict afterward....
“So is the traumatic event more than just the event itself — the event plus some crucial aspect of social environment that has the potential to either dull or amplify its effects?...
“To Dr. [Paul] Plotsky, this new view strengthens the argument for social interventions that have been shown to ease the effects of traumatic experiences — especially preschool programs for children at risk of trauma, and training for their parents.
“We can’t undo bad things that happen. But maybe we can reshape the environment that exists in their wake. As Dr. [Sandra] Aamodt puts it, that approach “has the significant advantage of being possible.”
So as much as the focus the Trauma-Informed Movement is having on children, we should not disregard the plight of adult survivors.
Last December, Daniel Lende wrote Trauma – The Importance of the Post-Trauma Environment for PLOS:
“Trauma. We often think of it as some event from the outside that hits us. That traumatizes us, leaving both immediate and lingering wounds. Like a gunshot to the heart or a knife to the belly. Something that decenters us, leaving not just physical wounds but existential ones that never heal."
Lende referred us to David Dobb’s aforementioned article which stated,
“Now, a significant body of work suggests that…the environment just after the event, particularly other people’s responses, may be just as crucial as the event itself.”
Lende summarized these points when he said:
“New research points us in a different direction, one of “Trauma Socialized.” Less injury and more context, where trauma itself becomes mutable, not a bullet or a knife but a social event formed by social interactions and cultural meanings….”
ACEsConnection member, Dr. Nadine Burke Harris stated clearly in an Oct. 2012 discussion,
“I think that everyone is asking the same question: "What do we do about ACEs?" I think that it's important for us to recognize that we are still in the discovery phase about how to respond, but that doesn't mean that we shouldn't act.”
I bring all these excellent threads together to remind us that struggling adults are very often the parents or family members of struggling children. Adverse experiences do not only exist in childhood; they do not end at 18 years of age. Family intervention is ideal but we must remember that to truly effect change we must strive to become conscious ourselves, ease the suffering of others, and not reinjure those with a multitude of polyvictimizations under their adult belt. We must continue to work not only on ourselves but, also, on our siloed institutions so they can work on effective cross-agency collaborations and put an end to the rampant unconscious retraumatizing communication styles that weave our dysfunctional societal fabric.
The National Education Association reported in their School Crisis Guide: Help and Healing in a Time of Crisis (p 31):
“After a traumatic event, most people will go through a cycle of grief and eventually return to a “new normal.” Reactions will depend on the severity of the trauma, prior experiences, personality, coping mechanisms and availability of support. For some, the trauma will become a growth experience. For others, post-traumatic stress will have lifelong, negative implications, and they will never fully recover.”
As Psychiatrist Schwartz sadly stated when he closed the NPR interview,
“…in some cases wisdom, patience and compassion aren't enough. He says sometimes suicidal intent is a terminal disease.”
We must educate ourselves about this dilemma and acknowledge this truth. It flies in the face of the Hippocratic Oath but we cannot put unrealistic pressures on adults who've had their brain architecture kindled by both psychiatric drugs and negative psychosocial experiences. We'd all like to believe that everyone can "recover." But to pressure survivors living at the end of the adverse life experience spectrum to believe they can get well when in reality they may never be able to do so, is misleading and unkind. They often acknowledge their very own limitations. It's just others that do not hear them.
Written by Chris Engel.
July 28, 2013
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